Provider Demographics
NPI:1043431240
Name:WESTERN MICHIGAN UNIVERSITY CENTER FOR DISABILITY SERVICES
Entity Type:Organization
Organization Name:WESTERN MICHIGAN UNIVERSITY CENTER FOR DISABILITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, BCBA
Authorized Official - Phone:269-387-7412
Mailing Address - Street 1:1000 OAKLAND DR
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49008-1282
Mailing Address - Country:US
Mailing Address - Phone:269-387-7200
Mailing Address - Fax:269-387-7212
Practice Address - Street 1:1000 OAKLAND DR
Practice Address - Street 2:3RD FLOOR
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008-1282
Practice Address - Country:US
Practice Address - Phone:269-387-7200
Practice Address - Fax:269-387-7212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care